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Copyright of História, Ciências, Saúde - Manguinhos is the property of Casa de Oswaldo Cruz and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of História, Ciências, Saúde - Manguinhos is the property of Casa de Oswaldo Cruz and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Since the 1970s, international research has actively pursued hormonal male contraception (HMC) and, to a lesser extent, thermal male contraception (TMC). Although the efficacy of TMC has been confirmed in limited populations, its acceptability has not been studied in either potential users or potential prescribers., Methods: A cross-sectional descriptive multicentre study of potential male users of TMC (new fathers) and potential prescribers of TMC (new providers) was conducted between November 2016 and February 2017.The participants completed a 3-part survey, and their responses were evaluated to i) determine their socio-demographic profiles; ii) identify personal experiences with contraception; and iii) gauge the participants' knowledge, interest and preference for male contraception, particularly TMC. For new providers only, the survey included a fourth part to evaluate professional experience with male contraception., Results: The participation rate was 51% for new fathers (305 NFs) and 34% for new providers (300 NPs, including 97 men (male new providers, MNPs) and 203 women (female new providers, FNPs)). Only 3% of NFs and 15% of NPs knew about TMC (including 26% of the MNPs and 10% of the FNPs, p<0.01). After reading information on TMC, new fathers were significantly less willing to try TMC (29%) than were new providers (40%) (p<0.01). The 3 main advantages of TMC for the new fathers included the following factors: "natural" (52%), "without side effects" (38%) and "non-hormonal" (36%). The main disadvantages were "lengthy wear time" (56%), "daily undergarment wear" (43%) and "concern about possible discomfort" (39%)., Conclusions: Young male and female providers have limited knowledge of male contraception, are interested in further information and would generally prescribe TMC to their patients. Successful expansion of the use of male contraception, including TMC, would require distribution of better information to potential users and providers., Competing Interests: The authors have declared that no competing interests exist.

Objective: To identify antenatal events associated with emergency caesarean sections in women presenting with antepartum bleeding and placenta praevia and to establish a score to predict the risk of emergency caesarean after a first bleeding episode has resolved., Study Design: This retrospective multicentre study included 250 women presenting with antepartum bleeding and placenta praevia from 20 weeks of gestation until term in three maternity units. The score was constructed from data from 163 women after identification of antenatal risk factors associated with emergency caesareans for profuse bleeding due to placenta praevia. It was validated on a second independent cohort of 87 women., Results: Three variables were significantly associated with emergency caesareans: major or complete praevia, defined as complete or partial praevia (OR=33.15 (95% CI 4.3-257); p=0.001), occurrence of 3 or more episodes of antepartum of uterine bleeding (OR=2.53 (95% CI 1.1-5.86); p=0.03), and a first (sentinel) bleeding episode before 29 weeks of gestation (OR=2.64 (95% CI 1.17-5.98); p=0.02). A fourth variable, moderate or severe antepartum uterine bleeding, was significantly associated with emergency caesareans in the univariate but not the multivariate analysis (p=0.006). These four variables were incorporated into a weighted scoring system that included major praevia (4 points), three or more episodes of antepartum bleeding (3), first bleeding episode before 29 weeks of gestation (3), and bleeding episode estimated as moderate or severe (1). A score ≥6/11 had a sensitivity of 83% and a specificity of 65% for predicting an emergency caesarean in the score development group and 95% and 62% in the validation group., Conclusion: A scoring system for placenta praevia with previous bleeding events, based on intensity, gestational age at sentinel bleed (before 29 weeks), number of bleeding episodes (≥3) and type of praevia (major) might be helpful to guide obstetric management and especially to determine the need for admission., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

An unusual twin pregnancy was diagnosed echographically at 18 weeks gestation and confirmed by magnetic resonance imaging. One foetus was in a pseudo unicornis uterus and the other in a rudimentary uterus cornu. The risk in such cases, as also reported in the literature, is rupture of the rudimentary cornu at about 20 weeks gestation. In this case the patient was carefully monitored to 23 weeks when the pregnancy in the rudimentary cornu stopped spontaneously. The foetus in the pseudounicornis developed normally to 38 week term. This exceptional observation emphasizes the risk of pregnancy in a blind uterus cornu.

We report a case of infantile polycystic kidney disease, during the course of two consecutive pregnancies in the same woman. Observed rates of recurrence in families at risk is higher than theoretical rates (25%). Antenatal ultrasound can show signs of bilateral involvement, which is always lethal and generally leads to elective termination of pregnancy. Diagnosis can rarely be made before 24 weeks of pregnancy.

We report a case of giant fibroadenoma of the breast, "juvenile type", in a 15 year old girl. We study the characteristics of this tumor that occurs in adolescents females, the differential diagnosis with cystosarcoma phylloide and benign virginal hypertrophy, and treatment. Follow-up is recommended because of possible recurrent tumor of a short time.

We report a case of hyperestrogenisation which showed itself by the presence of a haematocolpometra in an elderly lady which could be attributed to prolonged and continuous treatment with Promestriene cream. Haematocolpometra is due to intra-uterine haemorrhage (itself due to hyperplastic endometrial polyps) with vaginal stenosis caused by vaginal atrophy that existed before local treatment was started. The Pomestriene is an estrogenic substance which works locally and does not seem to cause much in the way of general effects when used for short courses. If when it is used in large doses over a prolonged period of time, however, it is necessary to look for generalised hyperestrogenisation. Further studies are needed to confirm these finding.